We, the undersigned, petition the current holder of the Office of the President of the United States, President Barack Obama, and his successor, to provide a guaranteed livable minimum wage for the Emergency Medical Technicians and Paramedics who serve the nation as its first line of healthcare.

Minimum Wage Rates for EMS Providers Falling Behind Cities, States and the Federal Government

In 2014, President Obama signed Executive Order 13658 also known as “Establishing a Minimum Wage for Contractors.” This Order raised the minimum wage for all workers on Federal construction and service contracts to $10.10. The President took this action believing that raising wages would improve the quality and efficiency of services provided to the government. It has been suggested that raising wages lowers turnover, increases morale, and leads to higher productivity. We, the undersigned, agree.

In 2015, workers across the United States petitioned for a $15.00 per hour minimum wage. The effort was born out of years of frustration within a workforce earning a minimum wage that both failed to keep pace with the cost of living and was often in a part-time position without benefits. Their petition garnered national attention; in response, a number of states and cities reacted.

The city of Seattle has raised its minimum wage to $11.00 per hour and plans to increase that wage incrementally with the goal of reaching $15.00 per hour by 2021. In comparison, the starting rate for Emergency Medical Technicians is often $12.00-$13.00 per hour.

New York State raised the statewide minimum wage to $9.00 per hour, but specifically increased the wage of New York City Fast Food Workers to $10.50 an hour for those employed by national food chains. In comparison, the Emergency Medical Technician starting rate in the city of New York is often $11.00 – $12.00 per hour.

What Makes Emergency Medical Service Providers Different from Other Workers?

The United States Department of Labor’s Bureau of Labor Statistics lists the 2014 Median Pay of an EMT as $15.24 per hour. This indicates that half of the EMTs assessed in the survey made an average of less than $15.24 per hour, illustrating the low compensation for a job described as being “physically strenuous and can be stressful, sometimes involving life-or-death situations.”[1]

We, the undersigned, believe the work performed by Emergency Medical Service Providers is significant enough to warrant a higher wage due to (1) the training required; (2) the number of hours typically worked; (3) and the nature and conditions of that work.

(1) Training

Minimum wage positions often have either no pre-requisites or require only a High School/General Education Diploma. By contrast, Emergency Medical Service Providers are required to be licensed either nationally or by their state. Emergency Medical Technicians complete 120-150 hours of emergency care education while Paramedics often complete between 1,200-1,800 hours.

(2) Hours

The majority of American workers primarily work eight-hour shifts, while Emergency Medical Service Providers work anywhere between eight and 48-hour shifts.

(3) Nature and Conditions

Due to their status as vital emergency personnel, Emergency Medical Service Providers work regardless of weather and often in hostile environments that would be considered hazardous. In fact, a recent study at Drexel University found paramedics and EMTs are 14 times more likely to be assaulted while at work than their firefighter counterparts[2]. More generally, studies have shown the national average of death rates on the job amongst Emergency Service Providers to be 12.7 per 100,000 compared to 5.0 for all workers[3].

Industry-Specific Challenges to EMS Providers Seeking Equitable Wages

Attempts by other workers to increase their wages have been successful in large part due to the ability of the corporations they petition to pass the increased cost directly on to the consumer. Attempts by Emergency Medical Service Providers to increase their wages have been unsuccessful due to the nature of reimbursement for their services, the inability of Agencies to pass the cost along, and the delay in receiving their reimbursements.

For instance, Service Industry Workers are reimbursed for their labor by the Service Employer, often a private company delivering goods and services directly to the consumer, who then compensates them for it, usually at the time of the transaction. In comparison, Emergency Medical Service Providers are reimbursed for their labor by the Emergency Medical Service Agency, which in turn, regardless of its designation as a private, municipal, or volunteer organization, is reimbursed in a fee-for-service model at least thirty days after the service has been rendered and only upon meeting a number of pre-requisites assessed after the date of service from numerous insurance providers. The largest of these insurance providers are the government-run Medicare and Medicaid programs[4], which also set the rate of reimbursement—regardless of the cost of providing the service.

Considering that the overwhelming source of income for all Emergency Medical Services Personnel comes through reimbursements via the Centers for Medicare & Medicaid Services, we the undersigned believe we qualify as providers of a service to the States and the Federal Government.

As such, we, the undersigned, ask President Obama to sign an Executive Order, just as he has done with Executive Order 13658, mandating that any Emergency Medical Service Agency receiving reimbursement for services through the Federal Centers for Medicare & Medicaid Services be mandated to reimburse their Emergency Medical Technicians at a minimum wage of $15.00 per hour and Paramedics at a minimum wage of $20.00 per hour. Failure of those agencies to comply would result in their disqualification from receiving reimbursement from the Centers for Medicare & Medicaid Services.

While we acknowledge that healthcare costs need to be controlled, we do not agree that low salaries are either effective or productive. Savings in healthcare should not and cannot be sustainably realized on a long-term basis by keeping service providers in poverty.

We, the undersigned, believe that such an Executive Order would result in an improvement of service quality, a reduction in turnover, and an increase in industry-wide morale, all of which would ultimately realize a higher productivity in healthcare that could be a true source of cost savings.